PERFORMANCE PEDIATRICS AND SPORTS MEDICINE, LLC – NPI #1295081321
Pediatrics

A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

PERFORMANCE PEDIATRICS AND SPORTS MEDICINE, LLC is a provider located in BOGART, GA. NPPES has assigned the NPI number 1295081321 to PERFORMANCE PEDIATRICS AND SPORTS MEDICINE, LLC on July 26, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2080S0010X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Sports Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PERFORMANCE PEDIATRICS AND SPORTS MEDICINE, LLC below.

NPI Profile for
PERFORMANCE PEDIATRICS AND SPORTS MEDICINE, LLC

NPI Number
1295081321
Enumeration Date

(about 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PERFORMANCE PEDIATRICS AND SPORTS MEDICINE, LLC
Primary location
1181 LANGFORD DR
BLDG 200-101
BOGART, GA 30622-2542
Phone: (706) 207-6694 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
TARA MERRITT
OWNER PHYSICIAN
Phone: (706) 202-3236
Updated
Identifiers

Identifiers for PERFORMANCE PEDIATRICS AND SPORTS MEDICINE, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERSTATE MEDICAL LICENSEGA58543
MEDICAIDGA003125239A
MEDICAIDGA489449582C
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080S0010X
- Pediatrics / Sports Medicine (Primary)
GA 58543
208000000X
- Pediatrics
GA 58543
207R00000X
- Internal Medicine
GA 58543

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.